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HomeMy WebLinkAbout08-13-08t 15056051058 REV-1500 EX ( -05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes INHERITANCE TAX RETURN County Year File Number - PO BOX 280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 ~~ 07 ' 1094 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 197-03-8575 i 11-1 4-2007 I ~ 11-23-1916 Decedent's Last Name Suffix Decedent's First Name MI Conrad Mrs. ~ Amy Jean __ (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI NA Spouse's Social Security Number _ _ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - _ _ - --'~ REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1/ 1. Original Return c~ 2. Supplemental Return c_~ 3. Remainder Return (date of death prior to 12-13-82) c~ 4. Limited Estate c~ 4a. Future Interest Compromise (date c_~ 5. Federal Estate Tax Return Required of death after 12-12-82) 11 6. Decedent Died Testate c~ 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) c~ 9. Litigation Proceeds Received o 10. Spousal Poverty Credit (date of death c-~ 11. Election to tax under Sec. 9113(A) between 12-31-81 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number S. Berne Smith, Esq. I 717-737-6789 Firm Name (If Applicable) S. Berne Smith, Attorne -at-Law Y I ~ ~' i REGISTER QF~WILLS USE {~'111LY First line of address = ~ , 107 N. 24'" Street ' - -- Second line of address - _._.. , __ ~ ;:, ' -,~~ _.. __ - --~- DA'1'~~FILED ~.,w City or Post Office State ZIP Code I .. _,.,_, Camp Hill ~ i PA I 17011-3602 ~:a Correspondent's a-mail address: s.berne@yahoo.com Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief. it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPO IBL OR`F.I~ John H. Groff, Executorjy ADDRESS `~' ~XrCVT6~ DATE 1 Chelton Circle, Camp Hil P 17011 SIGNATURE OF PREPARER HER THAN REPRE~S/ENTATIVE ~~, ~ ~t DATE/ S. Berne Smith, Esq. /~ , (~_ ,fit-~.._ `'' "" `~ _ ~f ~'~^ / ADDRESS 107 N. 24"' Street, Camp Hill, PA 17011 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 ~i 15056052059 REV-1500 EX Decedent's Name: Amy Jean Conrad RECAPITULATION 1. Real estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) ~~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c~ Separate Billing Requested 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H} 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Vafue of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J} 14. Net Value Subject to Tax (tine 12 minus Line 13) _- TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X 0. ' 16. Amount of Line 14 taxable at lineal rate X 0. 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable $185,735.46 at collateral rate X .15 19. TAX DUE Decedent's Social Security Number 197-03-8575 1, i $0.00 2. $244,949.19' 3. $0.00 4• $0.00 5. $148,795.02 ,_ 6. $0.001 r _ _ - 7• ! $252,896.49 8. I $646,640.70 9. I $18, 744.59 10. ~ $8,779.61 11. $27,524.20 12. $619,116.50:: 13. ' $433,381.04 14. ! $185,735.46 i 15. $0.00 I 16. $0.00 17. $0.00 18. ~ $27,860.32. 19. I $27,860.32 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056052059 15056052059 ~~ _~ REV-1500 EX Page 3 Decedent's Complete Address: File Number ~ 21 07 111094 I DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER Amy Jean Conrad 197-03-8575 STREET ADDRESS Messiah Village 100 Mount AI1en Road CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount ____ _ __ $6,000.00 $315.79 (1) $27, 860.32 Total Credits { A + B + C) (2) $6,315.79 3. InteresVPenalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) $0.00 (4) (5) (5A) (5B) $0.00 $21,544.53 $21,544.53 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1 Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ^ b. retain the right to designate who shall use the property transferred or its income; ^ c. retain a reversionary interest; or ^ d. receive the promise for life of either payments, benefits or care? ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one ^ year of death without receiving adequate consideration? ^ 3. Did decedent own an "intrust for" or payable upon death bank account or security at his or her death? ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ® ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (I)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)J. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1503EX+f9-98) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Amy Jean Conrad SCHEDULE B STOCKS & BONDS FILE NUMBER 21-07-1094 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 413.639 Shares of common stock of PPL Electric Utilities, Account # 3099043433 at $53.03 per share = $22,074.32 (Attachment B) 2. 19 Shares of common stock of Prudential Financial Inc. at $68.97 per share = $1,310.43 (Attachment C) 3. M&T Securities, Inc. Account # AZD-496149 (mutual funds) $162,207.72 (Attachment D) NOTE: The above values are good faith estimates of the date of death value. Through a misunderstanding, the actual date of death data is not on hand at this time. A supplemental return will be filed when the date of death values are obtained. These values are not necessary to compute the actual Pennsylvania Inheritance Tax owed by the estate, because the amount of taxable bequests and assets are known, and the full remaining tax due is being paid with this return. The same problem exists with some of the assets shown on schedules E and G with the same explanation. 4. Decedent owned at death many Series E United States Savings Bonds which are listed on Attachment E, being the Special Form of Request for Payment (16 pages). There was one $100.00 bond, forty $50.00 bonds, and 329 $25.00 bonds. (Note: these were all in the decedent's safe deposit box. The safe deposit box inventory listed 330 $25.00 bonds and 39 $50.00 bonds. This was an error.) The face value of these bonds is as follows: 1 x $100.00 = $ 100.00 40 x $ 50.00 = 2,000.00 329 x $ 25.00 = 8,225.00 The death redemption value of all of the bonds = $59,356.72 TOTAL (Also enter on line 2, Recapitulation) I $244,949.19 (If more space is needed, insert additional sheets of the same size) ReV-? 508 EX + (6-98) ~ ~-. SCHEDULE E COMMONWEALTH OF PEN //++ CASH, BANK DEPOSITS ~ M~SIi. NSYLVANIA , INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF Amy Jean Conrad FILE NUMBER 21-07-1094 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Federal tax stimulus payment for 2007 taxes was received July 2008 $600.00 2. Wedding ring. See Gem One appraisal, Attachment F. $100.00 3. Engagement ring. See Gem One appraisal, Attachment F. $300.00 4. M&T Bank, checking account # 24895660 value = $36,623.54 5. PNC Bank, money market account # 50-0350-3837 value = $30,368.47 6. PNC Bank CD # 000021001016345 value = $10,291.57 7. PNC Bank CD # 000031900056017 value = $15,980.80 8. PNC Bank CD # 000031200147936 value = $20,213.05 9. First Keystone National Bank CD # 8012423300 value (See Attachment G) _ $20,000.00 10. Sovereign Bank CD # 2335284127 value = $12,282.31 11. Investors Life Insurance Company of North America Policy # 04-4000874617, payable to the estate. Date of death value (See Attachment H) _ $2,035.28 12. Clothing -nominal value given to nursing home = $0.00 13. Furniture -none $0.00 14. Cash on hand -none $0.00 TOTAL (Also enter on line 5, Recapitulation) ~ $148,795.02 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) ~' ~. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF Amy Jean Conrad SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY FILE NUMBER 21-07-1094 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP To DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1. Annuity : Genworth Life and Annuity Insurance Go., 6610 West Broad St., P.O. Box, 27601, Richmond, VA 23261. Contract#706064411 $117,561.03 100.0°I° $0.00 $117,561.03 (No beneficiary other than the estate)(See Attachment "I" which shows the value as of January 1, 2008. This was a variable annuity.) 2. Annuity: AIG Annuity Insurance Co., P.O. Box 871, Amarillo, TX 79105-0871 $135,335.46 100.0% $0.00 $135,335.46 (This annuity had two beneficiaries, Nancy Ruth Hickey and Carol S. Groff. See Attachment J, a copy of the letter from AIG to Carol Groff, one of the two beneficiaries. A similar letter was sent to Nancy Hickey. Thus, the total value as of date of death was $67,667.73 + $67,667.73 = $135,335.46. TOTAL (Also enter on line 7, Recapitulation) $252,89fi.49 (If more space is needed, insert additional sheets of the same size) REV-7511 EX + {t~-061 1' ~~ SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES $c IN RESI DENTEDE EDENTRN ADMINISTRATIVE COSTS ESTATE OF Amy Jean Conrad FILE NUMBER 21-07-1094 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Auer Memorial Home and Cremation Service - $1,725.20 2. Funeral luncheon- $498.15 3. Church organist $100.00 4. Honorarium -two ministers and deacon $300.00 ' B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) John H. Groff, Executor $7,500.00 Street Address 1 Chelten Circle City Camp Hill State PA Zip 17011 Year(s) Commission Paid: 2008 (Estimated) 2. Attorney Fees - S. Berne Smith, Esq. $7,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant NA Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Cumberland County Register of Wills $400.00 5. Accountant's Fees 6. Tax Return Preparer's Fees Rick Simpson $300.00 7. Estate Notice -The Sentinel $142.66 8. Estate Notice - Cumberland Law Journal $75.00 9. Postage -certified and insured mailings and regular mailings $83.58 10. Littman Jewelers -Ring appraisals $100.00 11. Filing fees $20.00 TOTAL (Also enter on line 9, Recapitulation) I $18,744.59 (If more space is needed, insert additional sheets of the same size) REV-1512 E%+ 112-03) .. ` COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Amy Jean Conrad SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS FILE NUMBER 21-07-1094 Record debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. Dr. Paul D. Dalbey $7.57 2. Messiah Village Nursing Home $3,171.25 3. Alert Pharmacy $33.07 4. PA Department of Revenue income tax - 2007 $337.00 5. IRS Federal Income Tax - 2007 $1,739.00 6. The State Employees Retirement system -return of overpayment $2,400.72 7. US Dept of Treasury refund of VA overpayment $1,091.00 TOTAL (Also enter on line 10, Recapitulation) ~ $8,779.61 (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (9-00)) s: SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT FILE NUMBER 21-07-1094 ESTATE OF Amy Jean RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Nancy Ruth Hickey, 6 Blue Spring Terrace, Danville, PA 17821 sister-in-law $117,667.73 from Will and Annuity plus personal property 2. Carol Groff, 1 Chelten Circle, Camp Hill, PA 17011 friend $67,667.73 from Annuity plus personal property ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, ON REV-1 500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 3. St. Luke's Episcopal Church, 8 East Keller Street, Mechanicsburg, PA 17055 One half of the residue of the estate 4. Christ Memorial Episcopal Church, P.O. Box 363, Danville, PA 17821-0363 One half of the residue of the estate TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $433,381.04 more space Is needed, Insert additional sheets of the same size) LAST WILL AND TESTAMENT ,~ .- ., o . ,~ .~ _~~ ~~~ =; OF -_ -= ' ,_ ~ ~~ - ~ _ _1 - --~ ~ ,, ., xa ~ ; i.`,. AMY JEAN CONRAD : `= ~~ .. - r~ _ -__~ W I, AMY JEAN CONRAD, of Camp Hill, Cumberland County, Pennsylvania, being of sound mind and disposing memory, though I realize the uncertainty of this life, I have full confidence and trust in my Lord and Savior, Jesus Christ, in His death on the cross for my sins and in His shed blood as an atonement for my soul; and I know by faith that because of His sacrifice on the cross for me I have eternal life, do hereby make this Will, hereby revoking all my former Wills and Codicils: Article One: Tangible Personal Property: § 1.1 I bequeath all my tangible personal property in accordance with the terms of a personal property memorandum I may prepare. If no personal property memorandum is located or received by the Executor within 60 days after being appointed, after conducting a reasonable search for the memorandum, the Executor shall be held harmless for distributing such property as hereinafter provided. § 1.2 I bequeath the tangible personal property not disposed of by the personal property memorandum, or all of such property if no such memorandum is located, to be divided between my sister-in-law, Nancy Ruth Hickey, of Danville, PA, and my neighbor and friend, Carol Groff, of Camp Hill, PA, with each taking turns selecting items, with Nancy to make the first selection. Any items not selected shall be sold and pass as a part of my residuary estate. Article Two: Residue: §2.1 I devise and bequeath all the residue of my estate of whatever nature and wherever situated as follows: §2.1. l Fifty Thousand Dollars ($50,000.00) to my sister-in-law, Nancy Ruth Hickey, per sUrpes. . ~ ~~ C ib~`7 ~ tiT v §2.1.2 All the rest of my estate shall be divided into two equal shares and distributed as follows: a. One share as a charitable bequest to my present church, St. Luke's Episcopal Church, Mechanicsburg, PA, for the general Christian ministry of the church; and, b. One share as a charitable bequest to my home church, Christ Memorial Episcopal Church, Danville, PA, for the general Christian ministry of the church. Article Three: Provision for Debts and Expenses: I direct that any of my legally enforceable debts, any expenses of my last illness, funeral and burial, and any of the administrative expenses of my estate shall be paid from the principal of that portion of my estate disposed of by Article Two of this Will. Article Four: Appointiment of Fiduciaries: §4.1 I appoint my friend, John H. Groff, of Camp Hill, PA, Executor of this Will. If John H. Groff should be unwilling or unable so to serve, then I appoint my sister-in-law, Nancy Ruth Hickey, of Danville, PA as first, contingent Executrix. All references herein to the "Executor" shall mean my originally appointed Executor or any successor Executrix, as the case may be. Article Five: Powers of Fiduciaries: §5.1 No fiduciary under this Will shall be required to give bond or other security for the faithful performance of his duties. §5.2 Any such fiduciary shall have the following powers, in addition to those given by law: §5.2.1 To invest in, accept and retain any real or personal property, including stock of a corporate fiduciary or its holding company, without restriction to legal investments; §5.2.2 To sell, exchange, partition or lease for any period of time any real or personal property and to give options therefor for cash or credit, with or without security; §5.2.3 To borrow money from any person including any fiduciary acting hereunder, and to mortgage or pledge any real or personal property; 2 §5.2.4 To hold shares of stock or other securities in nominee registration form, including that of a clearing corporation or depository, or in book entry form or unregistered or in such other form as will pass by delivery; §5.2.5 To engage in litigation and compromise, arbitrate or abandon claims; §5.2.6 To make distributions in cash, or in kind at current values, or partly in each, allocating specific assets to particular distributes on a non-pro rata basis, and for such purposes to make reasonable determinations of current values; §5.2.7 To make elections, decisions, concessions and settlements in connection with all income, estate, inheritance, gift or other tax returns and the payment of such taxes, without obligation to adjust the distributive share of income or principal of any person affected thereby; §5.2.8 To allocate, in the Executor's sole and absolute discretion, any portion of my exemption under Section 2631(a) of the Internal Revenue Code to any property as to which I am the transferor, including any property transferred by me during my lifetime as to which I did not make an allocation prior to my death; §5.2.9 To create, except when the fiduciary is a beneficiary of the subject trust, with respect to all or any part of the principal of any trust hereunder, including a pecuniary amount, by a written instrument a general testamentary power of appointment within the meaning of Section 2041 of the Intemal Revenue Code in any beneficiary thereof and to eliminate such power for all or any part of such principal as to which such power was previously created and to divide trust principal into two fractional shares based upon the then portion of the trust that would be includable in the gross estate of the beneficiary holding such power if he died immediately before such division (in which case the power shall be over the entire principal of one share and not the other), with each share being administered as a separate trust, unless such fiduciary shall thereafter elect to combine such separate trusts into a single trust; to exercise the foregoing discretion to create or eliminate a general testamentary power of appointment when such fiduciary determines that the inclusion of the property affected thereby in the beneficiary's gross estate may achieve a significant savings in transfer taxes by having a federal estate tax in lieu of a Chapter 13 tax imposed by the Internal Revenue Code on the property subject to such power of appointment or may achieve significant income tax benefits; §5.2.10 To disclaim any interest I may have in any estate if the Executor deems such disclaimer to be in the best interests of my estate and the beneficiaries thereof; §5.2.1 1 To terminate any trust created herein, the principal of which is or 3 becomes too small in the Trustee's discretion to make the establishment or continuance of the trust advisable, and to make immediate distribution of the then remaining trust property to the beneficiary then entitled to the income of the trust property or, if there is more than one beneficiary, to the beneficiaries then entitled to the income of the trust property in proportion to their respective interests therein or, if such interests are not defined, in equal shares to such beneficiaries; provided, however, no Trustee shall participate in any decision to terminate such trust if by reason of such termination such trustee could receive a distribution of trust property from such trust as aforesaid. The receipts and releases of the distributee(s) will terminate absolutely the right of all persons who might otherwise have a future interest in the trust, whether vested or contingent, without notice to them and without the necessity of filing an account in any court; and §5.2.12 To merge any trust created hereunder with any other trust or trusts created by me or my spouse under will or deed, if the terms of any such trust are then substantially similar and held for the primary benefit of the same person or persons. Article Six: Provision for Taxes: §6.1 All estate taxes, inheritance taxes, transfer taxes and other taxes of a similar nature payable by reason of my death to any government or subdivision thereof upon or with respect to any property subject to any such tax ("Death Taxes"}, and any penalties thereon, shall be paid by the Executor out of the principal of that portion of my estate disposed of by Article Two of this Will, and al! interest with respect to any such taxes shall be paid by the Executor out of the income or principal or partly out of the income and partly out of the principal of such portion of my estate, in the absolute discretion of the Executor, without reimbursement from or apportionment among the beneficiaries, recipients or owners of such property for any such taxes, penalties or interest; provided, however, the Executor shall not pay any such taxes, penalties or interest attributable to any property included in my estate solely because of a power of appointment thereover which I possess but have not exercised or any qualified terminable interest property; provided further, however, the Executor shall not pay any supplemental federal estate tax, or any penalties or interest related thereto, imposed by Section 4980A(d) of the Internal Revenue Code, which supplemental federal estate tax, together with any penalties or interest related thereto, shall be borne by the recipients of the qualified plan benefit (including my estate if it is a recipient of any such benefit) giving rise to such supplemental federal estate tax in proportion to their respective interests therein. 4 Article Seven: Miscellaneous Provisions: §7.1 As used in this Will, the term "Internal Revenue Code" shall mean the Internal Revenue Code of 1986, as amended from time to time, or the corresponding provision of subsequent law.. §7.2 Whenever the Trustee is directed to distribute property to or for the benefit of any beneficiary who is under (a) eighteen years of age, or (b) a legal disability or otherwise suffers from an illness or mental or physical disability that would make distribution directly to such beneficiary inappropriate (as determined in the Trustee's sole discretion exercised in good faith), the Trustee may distribute such property to the person who has custody of such beneficiary, may apply such property for the benefit of such beneficiary, may distribute such property to a custodian for such beneficiary, whether then serving or selected and appointed by the Trustee (including the Trustee), under any applicable Uniform Transfers to Minors Act or Uniform Gifts to Minors Act, may distribute such property directly to such beneftciary's estate, or may distribute such property directly to such beneficiary (except if any of the conditions hereinbefore described in (b) apply), without liability on the part of the Trustee to see to the application of such property. This provision shall not in any way operate to suspend such beneficiary's absolute ownership of such property or to prevent the absolute vesting thereof in such beneficiary. §7.3 Except as otherwise may be provided in this Will, during the continuance of any of the trusts created under the provisions of this Will, and thereafter until the property is distributed to and received by any beneficiary hereunder, the principal sums thus held in trust for any beneficiary, respectively, and the income thereof shall not be subject to or liable for any contracts, debts, engagements, liabilities or torts of such beneficiary now or hereafter made, contracted, incurred or committed, but shall be absolutely free from the same, and such beneficiary shall have no power to setl, assign or encumber all or any part of the principal sums or such beneficiary's interest therein, respectively, or the income thereof, or to anticipate the income. 5 §7.4 If any beneficiary hereunder should die within thirty (30) days after me or within thirty (30) days after any other person the survival of whom determines his rights hereunder, then such beneficiary shall be deemed to have predeceased me or such other person for all purposes hereunder. IN WITNESS WHEREOF, I, AMY SEAN CONRAD, have hereunto set my hand and seal to this, my last Witl, typewritten on seven (7) sheets of paper, including the self-proving attestation clause and signatures of witnesses, this L ~1 ~, day of _ ~~ r , 2000. ~~ (SEAL) AMY CONRAD Signed, sealed, published and declared by the above named AMY JEAN CONRAD as and for her last Will, in the presence of us and each of us, who, at her request and in her presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto the day and year last above written. Residing at ~'~ ~'t - ~~ Residin at g ~~.~----~ i~~---~-~i~ _Residing at i - o u E ~, v F.~ ,-n ,~ ~ ,a~~ ~~ N o c rr ~ /7 . ~ 7 v Z S' 713 t ~ ~ tc v , ~,..i Gc R c~ d _ 1p ~ IU ~ Z ,, '-t fr COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND SS. We, AMY JEAN CONRAD, the testatrix, and 0 2 0 , ray / ~ . .~/1 w ~ ^~ cJ u ~ , ,e ~ - f'T c.t •v a T ,and 6 c~NC= ~/? i%~' ,the witnesses, whose names are signed io the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last Will; that the testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the Will as a witness and that to the best of his or her knowledge the testatrix was at that time eighteen (1$) years of age or older, of sound mind and under no constraint or undue influence. ~ ~~~ Q~ AMY JE C RAD Witness fitness Witness Subscribed, sworn to and acknowledged before me by AMY JEAN CONRAD, the testatrix, and subscribed and sworn to before me by ~~ R o fi~~, ~- ~/Z W ~ ~v /`fI ~Y , 2000. U L 1 p ~- ~?~ U R /g •t the witnesses, this 2 ~ '~ Notary Public My Commission expires: SEAL and day of Notarial Seal laure E. Kane, Notary Public Hampden Twp.. Cumberland Counttyy My Commission Expires Nov. 15, 2W3 Member, Pennsylvania Association of Notaries uiviaena Ke~nvestment Plan Account Statement ~'JMPORTANT' R' •~~~'~~~ ~ ,~• . etatn this .• •.• .- t ___ statement for yourinvesdr-ertt, tax aric! ~st}~a~s ~~ds. • Questions. U. S. telephone number TOLL FREE: 1-866-280-0245 Outside U.S.: 651-453-2129 ~~t •: ~-_ Far online account information, please visit www.shareowneronline.com • - Fax number for transaction requests: 651-450-4085 `• T ;- _ Cusip # 693517106 Account Summary JOHN GROFF EX EST AMY JEAN CONRAD 1 CHELTON CIR CAMP HILL PA 17011-8427 Year-to-Date Amounts -Common Gross Dividend Reinvested Federal Tax Withheld -~-Nonresident Alien Tax Withheld - Cash Investments Total Invested Commissions Paid by Company PPL Corporation Page 1 of 1 Account # 3099043433 Share Balances Record Date Div Reinvestment Plan 333.639 Certificate(s) 0000 Direct Registration 80.000 Total Common Shares 413.639 Current Dividend Record Date $138 57 Payable Date $0 ~ _ Dividend Rate -Common ._ --- - $0-~ __ _.- -- - Account Value $0.00 Market Value Date $138.57 Market Value Price -Common $0.10 Account Market Value -Common Year-to-Date Activity Transaction or Transaction Settlement Date TYPe Gross Amount of T Taxes Net Amount of ransaction Withheld Transaction BALANCI;FORWARD ' ~~~"-- -"-~- 05!19/08 - Transferred In , S ' ~" $0.00. $0.00 .. _ 00 $0 07/07/08 ~ Div Reinvested ' '$'138.57 $0.00 . $138 57 . -; .. Price Shares Increased per Share or Decreased $0.0000 33;is639 552.8550 2.822 '- July 2, 2008 Current 336.261 0.000 50.000 416.261 06/10/08 o7ro1/o8 $0.335 07/01!08 $53.03 $22,074.32 Total Shares Held !n Plen 0.000 333.639 336.261 ,~U t, Y p ur Plarand/or DRS shares electromcatly delivered to or from Pour shareowner accountpFor nfo matio' concerning authorization oRelectron c hare~sement, plea ~ °.. se contact your Broker/Dealer. Detach here. Forward bottom portion to fhe address shown below. Forother bansacbons see reverse side. Transaction Request PPL Corporation Account # 3099043433 Mail to: Shareowner Services OPTIONAL CASH PURCHASE ELECTION PPL Corporatien PP01 ^ Enclosed is a check made payable to Shareowner Services Dividend Reinvestment Plan PO Box 64856 for: $ St Paul MN 55164-0856 ^ Please change my address as indicated Maximum 580,000.00 per year . JOHN GROFF EX The deadline for Shareowner Services to receive your payment is 5 p.m. CT on JULY 31 2008 EST AMY JEAN CONRAD 1 CHELTON CIR , . Shareowner Services will process your purchase instructions CAMP HILL PA 17011-8427 according to your Plan prospectus upon receipt of your properly completed request which includes account number or SSN and reference to the PPL Plan. We will not be liable for any claim arising out of failure to purchase shares on a certain date or at a specific price. g I ~~~ M9 ~~9~N I~~ ®Y'I'~ ~A'u~ ~a ~~ I~ Requests submitted on this form will only affect Dividend I I~tll I~il ~I aa,'I I~I I~ Reinvestmetrt Plan shares, not shares held in DRS. - ---- - -- -- -....--- ~t Pur Bti Sell your shares -°oldic-l ~ PRUDENTIAL FINANCIAL INC COMMON STOCK » 1. Order Entry » 2. Review and Finalize » 3. Confirmation The proceeds from your sale of PRUDENTIAL FINANCIAL INC COMMON STOCK will be sent to you in US DOLLAR(S). The estimate below is based on the current market price of the stock. ~~ rake >: ui t lid©te: V~a~c i?r-`aaa9 ~^'~cp~~s are a9eter^~ir^~ "^v "fit= price ®f t'~~ ~~c~arity o~•~Se~^" "ae Itra-'a 75 E;3t~QjbJit^'~. Batch sales requests entered after 2:00 P.M. Eastern Time or on a day the market is closed, will be processed the next day the market is open. Trading Details Transaction Date 31 3ui 2008 Sales Type BaCch Number of shares to be sold i9 Estimated Market value per Share 68.97 lstimate~i ~F©5S Pr43~^eed5 Il, ".®.4.i Estimated Fees Trading Fees 12.52 Estimated Total Fees 12.52 fstimated Rfet Pr~sceeds ?,<"~7,g3 Payment Details Currency USD Payment Method Check 'lease Vote: ®nce you summit your order, it caa~not be changed. Please re-enter your Password to authorize this transaction: Cancel _ < Previous Submit © Reuters Limited. Click for Restrictions. Copyright ©2008 Computershare Limited. A11 rights reserved. Reproduction in whole or in part in any form or medium without express written permission of Computershare Limited is prohibited. Please view our Terms and Conditions and Privacy policy. Tel C s>~ !~ t i/ '~ C_-- https:!/www-us.computershare.comlInvestor/P1anSale/SellOrderInstruction.asp 7/31 /2008 0 v N ~g r ~~ 1 ~' v? N Q 0 ~ 7 T ~ ~' S ~o n ~ rr- n d Q 6 ~+ O S W d O Z O n S n o_ ~' N a ~, 0- a c ~ ~~ g RT N m tJ IO^ W ~~~ ~~~ ~~ ;~~~ J ~~ O ~ ~ N ~~ J ~ Q~ ~ ~ ~ ~~ a+ m ~. P '"'} z s~~ ~; ~~~ ! ~ n -"' O S n ~~~~ ~ r Q~~ o N __ rz7°n -on~0 y,~~z .p < °rnyd ~,,, ts7 0 "" ~ W N ~`' :. ...1 :.. ~- _,,.. o Y a ~ .... ...+ ~ r ~ d o w :. :.. 8 O O O O C nO~ s ~° i "o~ ' C ~ ~ ~ ~~ ro O ~+y i N ~ i. ~' A f 1.~ ~ N e~i O ~pp ~ O ~ r O ~ O ~s f r r M n~ ~~ For official use only: Customer Name Customer No. PD F 1522E SPECIAL FORM OF REQUEST FOR PAYMENT OF OMB No. 1535-0004 Department of the Treasury UNITED STATES SAVINGS AND RETIREMENT Bureau of the Public Debt SECURITIES WHERE USE OF A DETACHED FOR oFFlcuu. tISE ONLY (Revised Feb-uary 2006) REQUEST IS AUTHORIZED TRANSFER MONTH 8 YFJ-R ! FISCAL AGENT CODE 1. DESCRIPTION OF BONDS I am the owner or person entitled to payment of the securities described below. which bear the name{s1 of M~C`~ r~.l~Y _I'r~h1 <~.~ tit= p.p ~ A Mu LF~-. S Go ,~ ~=~ ISSUE DATE SERIAL NUMBER ISSUE DATE SERIAL NUMBER ISSUE DATE SERIAL NUMBER ~Ei'Ci~il~• (/'.'-(}~~`"ji/3r:;~~G (7~.Gi°l7 L~tt''7~i~'~1C>'-~-1=,=, M/•~j~i~~' L~i~~JSC~'~l>r~(~!~ T/~N 1 `~(~ Ltv I `1v~~c? ~~`Y ~ bi=C.i97'7 i_21v7`1 J~ ~-- i& ~ t~'t~~ict7~ L-Zi t ~i~~=%~~~`f~ E ~UC~1'1tG L(o?~Cc3c~i2Gui_. .7ANi`17N L2iiZ~-t "I~~`t~Ic ISr~'(Zjq~~; L..Zi2~7~c &~~~`F 1~1~1?l~fl~5 L. (o'-1-J-"vG~j i`1coE ~j" ti ij72~ L2i 1 ~~v•-Fv~fSE A~i`77"~ L.2 (Z75~/.~Z27E ~u~l'7c~, i_-l y~ i ~ti-2 771-~-C r=E.B-`i~t> ~2 i i 5`t~~ 13 ~~ E Ni1~Yi~c7~ L2t277~t- ~v ~ t E .JAIv+`t~-~r~ i_7?-7~5`t3i~t.:. ~31-~7~ L?i1Sti~`iv3<:sE 1v1AY1`t7~ L~ i27~5c3~~E v~ I i 1~1 L7J7G~v~~~'s~`J_~ MA(:1~17~7 1...'? i 1S4'1/,v ~~~ UPII`i7u J Lr' i 3'-r•`~1f'~ fn you neea mole space, use the contirsuation sheet on page 3.) 2. REQUEST FOR PAYMENT I request that the described bonds be redeemed and payment be made in the form of ~ a check. Direct Deposit ^ To the extent of: (Complete this line only if partial redetnpEiott and -eissue of tl-e remainder is desired or if the signer h only ent-Ned ib a portion of the bonds listed. See Kem 2 in the Instructyons.) I 2Co - (v i ~ 5~iy i (Social Security Number of Payee) OR (Employer Identification Number of Payee) 3. DELIVERY INSTRUCTIONS (Read Item 3 in the Instructions before comp/etii-g this section and complete oMy Item 3A or3 B.) A. MAIL REDEMPTION CHECK TO: (Name) (Number and Street or Rural Route) (City) (Stabs) (ZIP Code) B. DIRECT DEPOSR FUNDS AS AUTHORIZED BELOW: ESTATE ~i= AM•Y J ~N GoNKA~ ,~vi_}a ~ t~Ra Fr ~ x.~ ion (NameMames on the Account) ~~ Cr',Git ~`i Cv (Depositors Account No.) Type of account: ,Checking ^ Savings Bank Routing No. Q~ t 3 U I~ `'}' w G'c~MMr~c+~ BANK I-8~8 -y37 --o~~~ (Financial Institution's Name) (Phone No.) 4. SIGNATURE You must wait until are in the presence of a certifying officer M sigh this form. Sign Here: ~ F X >=C U d~' `.I Q t-1 lJ L~ . ~ ~L FF ~X / ignatu a (Print Name) Home Address t G't-1 E lrT ~ N L i ~L Li= j~ y ~ ~ N ~ ~ 1 ~ , i~0 L • LO M (Number and Street or Rural Route) (E-Mad Address) ~~M P ~-i l LL P>!~ 1 ~t ~? t l (City) (State) (ZIP Code) (~-~ (-~~ ?~•3-7~( t (Daytime Telephone Number) CerMying ORicer -The individual must sign in your presence. Complete the ceibficaBon and aflor your stamp a seal. I CERTIFY that ^JONiU ~ ~/POF~ ,whose identity is known or was proven to me, personally appeared before me this /97~ day of ~~NUA~<' l./ ~ ~C7N~~ , (Month) (Year) at ,~~J1Lp ~', and signed this fo (~ (State) /~ ,vim / M $`T ~p PARK b (Sign/aCture of Ce ' cer HIGHIA ~.r F r JAN 1 9 ZiICIAL STAMP R otCertifyingofficer) GR SEAL) ~/,~'~ _ r ~P~~`" '~`-` (-Number and Street or Rural Route) (Cif) (State) (Z~f Code) ~jQ . ~ .,~ • ~ r'~ ~ 9~ ~~ j '~~ °Z7 ,D RESERVED FOR IDENTIFICATION NOTATIONS ^ Customer Account Number and Date Established: ^ Document(s) -Description: ^ Identified by (Signature and Address): INSTRUCTIONS TO CERTIFYING OFFICER Each person appearing before you must establish identifgtion by positive and reliable evidence before this form is signed, unless he or she is personally known to you. Place an adequate notation above or on a separate record, showing exactly how identifption was established. A notation is adequate if it is sufficiently detailed to permit, at a later date, a determination of the exact identification actually used. You and the organization will be held fully responsible for the adequacy of the identification. The signatures to the request must be executed in your presence. Fully complete and sign the certification form provided for your use for each signature you witness. If you are an employee (rather than an officer) authorized to certify signatures, insert the words "Authorized Sgnature' in the space provided for the title. Insert the place and date, as required on the form, and impress the seal of your organization. PRIVACY ACT AND PAPERWORK REDUCTION ACT NOTICE We're asking for the information on this form to assist us in processing your securities transaction requests. Our authority comes from 31 U.S.C. Ch. 31 which authorizes the Treasury Department to borrow money to pay the public debt of the United States. Also, 26 U.S.C. 6109 requires us to use your SSN on certain forms when we report taxable income to tRS. k's voluntary that you provide the requested information, but without it, we may not be able to process your transaction requests. Information concerning your severities holdings and transactions is considered confidential under Treasury regulations (31 CFR Part 323) and the Privacy Ad. However, the following routine uses of this iniortnation may include disclosure to the following persons or entities: agents and contractors who help us manage the public debt; others entitled to ltte seventies or payment; agenaes (inducting disclosure through approved computer matd-es) detem-ining eligibility for benefits, finding persons weave lost contact with, or helping us coiled debts; agencies for investigations or prosecutions; courts, counsel, and others for litigation and other proceedings; a Congressional office asking on your behalf: and as otherwise authorized by law. We estimate it will take you about 15 minutes to complete this form. However, you are not required to provide information requested unless a valid OMB control number is displayed on the forth. Any comments or suggestions regarding this torte should be sent to the Bureau of the Public Oebt, Forms Management Officer, Parkersburg, WV 261061328. 00 NOT SEND completed forth to the above address; send to correct address shown In "WHERE TO SEND" in Ure instructions. (2) continuation of descriofion of bonds in Item 1: ISSUE DATE SERULL NUMBER ISSUE DATE SERIAL NUMBER ISSUE GATE SERIAL NUMBER JUN i 17b L'' i 3 ~i-''-t•'t Z 3 2c~ '~ t- P" C. L ' r 3 L~ > i ~; o ~i C ~. ,~U b j ~ . ~ v -, - r. ,JULi~l78 ~Z i3~-4-~i-Sl~c`~;E OC,i i`~i:;z .~ •~ - -, ~~i~ ~ SEPI`1(~'~ >ZOio4~3Z~~5E J u L i `i -1 L'; L ~ i 3 '--F-'=!• 5 ~ ~ !2 E C3(.1 `'1 2 1 ` ~ t~ ~~ Y> -13i i~ 5tP i `I 4~`~ ~' Zc.~l. ~ '-F~: 3` y 17 8 ~ %~~ica l`i 7t~ ~2 i 3 `f'`-fW L- t~4~ C NCY !`i~l G2 +`- 5i` 2i~o`7Ltd r; StP i`~I(o4 Z~ c-1 !7 5~Z3 E ,~tdU i`t7z~ i^2 i3`~ct(o~~~f-G~`i r- MAi; iti~~i ~~+''Ib~f2i i 5c~c c Cc_.T r~l~`~ ZC '-~i5`~t~ts` f~i.1 L~ l `17~ LZ i ~i `7 x-14; 8 ? 7 S r= f~ . l `7 b~ C~ i ~ i c-+ c3L ~'7 E d ~T ~~ ~ ZC^ ~ t G' ~ SS y (O E SAP iH7$ L2 i ~`t'`F~ ,~ 3nE ~/IF!`f i`1to3 '' `1 `1 G:J~ Z"Li`'I ~ NcU ~' ~ Zv`, G~ 7 E Ste(' i~~18 ~-2i3`~~-7~+4C~i E (v!/{Yi`~~:3 ~~. 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(3) Print Refresh PD F 3500 E Department of the Treasury Bureau of the Public Debt CONTINUATION SHEET FOR LISTING SECURITIES (Revised January 2007) PRINT IN INK OR TYPE ALL INFORMATK)N The bonds described on this form are included in the attached PD F 1 ~ 22 t= ISSUE DATE FACE AMOUNT BOND NUMBER INSCRIPTION (Provide complete Social Security Number [for example, 123-45-6789), names, indudin mid dle names or initials, and addresses on the bonds) Nr/v Ialb-7 Z~ (;~~~c:~(vG~f~z1~ _ rZN ?~,- lam!? ~3U i > ~~~~ ~ N~'~ iH~~ L5 CUZ ?~:~ ~o7~t~~? - c> 5.5. iq Dr c., (`lG:,_J Z `~ ~ ~.?~ l i '7 3`~i (,`15 ~ ~ ~ c- .s L: r~ - L(5 ~..F_ r2 ~~ i-~ c~, ~ r r ~F~ I~'1~7 Z~ Z ~ i 1533Z`77 ~~M~ t~(L_L_ P~ JArv ~ `1(~n Zf" ~ 2 ~ Z'?'? IH7~k a~ S Af~iUitt- 7- C.~;;J - ~i~ Ft~-~ ~n[ ~~ Zvi ~ 2~i2 ~a7`i3`!Z ~ Irv ~~- ~ iZ ~~3o I Z5 l~ Z3L ?v~=~ 7`~5`~ ~ ~n~ ~. ! "I (v ~ Z `~ C~ Z ~ L 3 Z7 v '-~ 7 ! F_ i -~ ~- a tiN ~ t_.i-. ~ T~ i ~ E Miaf` !`~~~~~ 25~ ~;23Z3Z~~=»~t~>~ C;an~P Hf~t~ PA i~7~jll ~~ t ~'t ~~ ZS ~ Z7Z32`~c,i~ .3 F v~ %~~ J C (~ c~v - ~:~Mii~L- M AY l ~i (v b Z~ Gr 2 3 L t5 t 2 y ~7co F ~JVN ~ f`7( ~:~ G7 C:~23-}I%'ilo`f(UL'c J~t1v !`9rv~ Z~ C,~ Z3~fl~ t ZC.~;3c ..i~ti_ iy~~~~ ~~ c~Z'3~v33~,~~3E ~~~ I`~~ ~5 ~Z:~i+7r,`~~~Z~ l~UCa I `IG~~~ Z5~ " 23c~ i ~~ ,`f~i ~ ~ ~ ~ ~'~ lri ~' 7 ~j ~'~ Z " ~. 1~:.1 W I t 7 C~ `' ~- ~~ ~ E~ECV1-aie M&T BANK ~ (Signature) HIGHLAND "P" / JAN 1 9 200 ~~; ~~~~~/~ ,~ cx -~ , ~~a~-~~ ~ ~ c~~ ~~ ~ °D F 3500 E Department of the Treasury Bureau of the Public Oebt (Revised January 2007) Print Refresh CONTINUATION SHEET FOR LISTING SECURITIES PRINT IN INK OR TYPE ALL INFORMATION The bonds described on this form are included in the attached PD F I ~ ~ ? E ISSUE DATE FACE AMOUNT BOND NUMBER INSCRIPTION (Provide complete Social Security Number [(or example, 123-45~789J, names, indtxii middle names or initials, and addresses on the bonds) S ~'C' t ~1 ~.= ~' ~ '~ Gl L 3:;11 i~ i% `j 2 E ~ i tv Z w- W t ~ '~ 3 ~ i ~(;7 I `1c~8 G ~ G'123ii; ~~°:t~ v'1 c;C~ M R.•; AMY ~ c~N Gc;~l SAD I > R~1 G ~ ~ ~" ~ (J ~~ J i `1 ~~ 2 5 Gc 2 3 c o >r' :; 7 71-tZ i= ~ 1= t__t_ ~ t G ~~. `n r K 1 L ~.- ~~. t~ v i l ~~ i`i~~, 2h C~23~Z~t7c~tiv5E S~>rn uRL -,~ c.c;;J- ~n ~r~ i`~~`~ ?ti q?3~~2`~~~53r I~1~r` i~i~`t 2~ C1~~tv?~~i-3`~c~4:E ~/i ~~~' ~ `1 ~`1 SG r_-T ~ 5 2`r3'-}' ~ `-t'7 E ArP~ i°I~y 2~ G22~~Z35 ~2Sc>i= ~P~.I~1~,`~ 25 Q~4v?3~~~~~~F iv1AY l~t~`1 ='h G'~24oZ~4.3~~~`l~ rYl aY i~ t~`j 2~ Q 2 ~# I ti-~i o 2 .~ ~o E ~uN Iti~`~ Z~ QZ~ti ~~;t Z7~~%E SUN -~ ~`1 2h G~2~Z~y~+ 13 t-1G J is i- i ~ ~ `i 2 ~ -_~„~ ~2 ~+ 3 L~ I ~ h C,~~ ~. Jv1L -`1(;`1 2~ C,t2~F3~vnv`:Iv9r_ ~~U i~I~`~t ?~ C~243~~~~3 2`1~F ~',c ~c v o~ Signature) M & T BANK HIGHLAND PARK ~l ~ JAN 1 9 X008 ~/ c~~ ~. Print Refresh PD F 3500 F Department of the Treasury Bureau of the Public Debt CONTINUATION SHEET FOR LISTING SECURITIES (Revised January 2007) PRINT IN INK OR TYPE ALL INFORMATION The bonds described on this form are included in the attached PD F f ~ 2 ~ ~ ISSUE DATE FACE AMOUNT BOND NUMBER INSCRIPTION (Provide complete Social Security Number [for example, 723~t5-6789), names, indudi middle names or initials, and addresses on the bonds !-~ U G, I q ~; `=1 2 5 ~ 2 L 1- 3 ~ `i ~~ 3`iv ' E I N 2 C o -~ i 2 ~ ?7 o I ~~l i ~ ~~ 2~ , L ~7 Q L'T ~j(J ~i 7 2L7~7 ~y - 7 U ~~ [ "1 ` - v ~ - lJ 7 ~ SCE' 1~~~~ 2S C,~%~'-~4~`t-9 (tDS~~ n 'v,~~`~ ~MY ,_~t=/~t~l Gci'Jt2~~ - c/C i t ~lo~ ~ 5 ••, . `-i• > 3'1 G i <i c:, 0 E i 7 L ur~.fv c L i_ Tj R I V r= ~; i I M ~ i--i i Li i N ~~ J+ `~t ~` 7 2 5 ~ Z'-+ ~ 3 ~ I l ~`f- i~ . ~,~ 1 ~ c^ l t v 2 Nod ,'i ~`1 27 <-~r2~5`1'_5 L'7S`1 - S.~M~~~-- ~T C.aN2%~D i~ i= L i `~ ~~ ~'~ ~ 2'-~ toy i ~ iv Z3ir~ E Jury ~`1~0 ~5 ~;25c::;7~?v3~~` G `~ ~ ~ 5a 77<<~ 55~[ r= .,)i.1L i X17% ~5 ~L~v 77 ~lo~-F-T~C i~uG l `~ 7c~ 2 ~ cxZ~ i ~+c:~ ~ z5~'~~ r /kc..l Ca I `~ 7G L 5 t=,;' ~ `~ 2 ~ ~' i L~ i c, ~~ G 5~C' 1 ~z7o 25 c;1~52v~~' ~v=i~ ~. 5EP (y7L' L.`~ Ca~2`~2C~~3 G~j ~jF c1 ~"i i ~7 lC, ?':i L;t~ 2 72 77~ ~ ~ ~~i,~ c GG ~ i `~?0 2 h 4~2~2 7730 ~~w E ~.1oU i~ ~v 25 ~~:~33~ 7~ ~~5 N~~~ i ~ ~~o ~ ~ X253 35~~s ~42~t r ,~ ~Ecu?-~~ Signature) M & T BANft HIGHLAND PARK ~ I I JAN 1 9 2;`iiJ~ ; ~ ' ~ r ~ PD F 3500 F Department of the Treasury Bureau of the Public Debt (Revised January 2007) Print Refresh CONTINUATION SHEET FOR t_ISTING SECURITIES PRINT IN INK OR TYPE At_L INFORMATION The bonds described on this form are included in the attached PD F (~j 2 .Z C ISSUE DATE DEC I''a7G FACE AMOUNT ,~'~ 5 BOND NUMBER ~GS3y ~4 1Z~,iCC INSCRIPTION (Provide complete Social Severity Number [for example, 123-45-G789J, names, indudin middle names or initials, and addresses on the bonds) s/ iIJ ~G, -~:=i2 S 3~~ i Dec. -`r~o ?~ G~~~3•~Zt7 i~~`rE S`~ i~l~ --~3 - £~5~5 S7~(:. 1~~7C` ~5 C~ZS?~"jJU`t~~~IC~~ Ml?'_~ Al~/~~( ~J~-l~tJ c_..vN~'~~ 17~~ !~[-7G ;?'~ C:;i273~TS~3v~i.;E f-7 ~v~rU~~.~ ~~~v~ J A N i j l G 7 C,% Z -j ~ '] ~7 G~ C:~ ~] t:: E ~- ~'~M P H t ~.~ ~ •~ I~ v i l ~, .-~ `-F C7 ~ `1`11 Z 5 -~ ~.. (:;~`S(S~~tS~+ti~E ~ r~ M V g 1_ T ~?~ s~ 7 - ~y C~?~ l s`7~~-7~~ E l~ 1 ~`I 71 I Vl ~.'~ C{ ~.7 l 5`(7'-~-C, l; (o E g ~ /'Ct' ~ 1 ~'l ~ f ~'7 C~ L yJ ~ ~ L to ~ `( -T 3 C i~Pti. iG ~ l 27 c~2~<0 2"7 SZb~ E lvi a.Y - ~-t ? t c ~ c;~ z ~ £~ U i= ~~ 3 i l v E ,`,~ A`( 1 `17 i 2 ~ ~ 258a Z`1 'z 2~5 G .iUN i`~~11 ~~ 2~iS~~~~~~~i~ JAN ,~~1 l L~ C~?7~s~~ i5~'(vi~ .jc,ityi~j~l ~7 t:~?5L~°?~5~(vfifr ~~~ ~ ~17i ?5 ~iSS ~~_~`toS7~~ -~ GU d~ M & T BANK % • ( 9nature) HIGHLAND PARK ~r ~ J N 1 9 2008 ~- ~ , ' ~~ Cu' Y ~ ~ ~/mot nx , ~ ~a~r~ ' (~ c~ A Print Refresh PD F 3500 F Department of the Treasury Bureau of the Public Debt CONTINUATION SHEET FOR LISTING SECURITIES (Revised January 2007) PRINT IN INK OR TYPE ALL INFORMATION The bonds described on this form are included in the attached PD F i ~ 2 Z i/ ISSUE DATE FACE AMOUNT BOND NUMBER INSCRIPTION (Provide complete Social Security Number [for example, 123-45789], names, indudi middle names or infials, and addresses on the bonds /~UU I"t-T, GS C~~5~~t3i70C;~ rIN 2Co-Cv1~~3c>>+ SI=P i~t11 ~5 ~~~58~oZ~:z~t`7 S~ 117- C7~ -~57`~ SE< < ~ 1 r `5 C~2~~t>v ?~-t-`=i i ~.'~ M125 l~MY .J E~>`i Gcjty ~~ O~i l'i'Zi 2~ C~2~S~vy-~Jitul~ ~ C."vi2tv~i..~ ~IZ1~/E ~ - O L i 1 GI 7 I ~~ Cx' ~ (oO(~ O'T ? !~, v '-f-C C F1 r~ ~ t--1 I L - ~~ l 7 o t i G2 ~] ~'J i `1 ~ i G ~ ~ 2 ~:,~ C~ (~~ O d (`t` 1 ~ 5 ~~ M ~ ~: L .~ G. c.% h) ,2 ~-~ ~~L ir~1l ~5 C.2~~U(vI~55`iIC D~~ it~~ ~ ?~ c~~~~a;~:~~-. s5 c J !~N i r1 7 ? ? 5 ~? 2c:,: tf_;' i 7 7 `t3r~: ~ ,JAN i~1~? L`~ C~2c~ir>>i~'5~~~-~~ i"E'u -'i~2 L~ ~2~(S i~z~ ~7vE ~v1~t`. i`172 `h c~~~v3v~t~7L~=~L= ~~~~ i ~~ 72 ~.5 ~ 2c~ 3v`i y-3~~ i [= APP I`i~~ ~~ c~~~3c~r~~' i~Z~ Mp,~; i~7? ?~ ~L~"3oy~~~s~E MfaY Iti~~ ?~ ~~i~"3v->'~1r~`~73r ~ ~, '1 ~~ o M ~ T BAN}C (Signature) HlGHLANn PaaK / ~~ JAN 1 2608 ,~ l-~ ~~~ , Print Reftesh PD F 3500 E Department of the Treasury Bureau of the Public Debt CONTINUATION SHEET FOR LISTING SECURITIES (Revised January 2007) PRINT IN INK OR TYPE ALL INFORMATION The bonds described on this form are included in the attached PD F I~~ ~ ~ ~. ISSUE DATE FACE AMOUNT BONS NUMBER INSCRIPTION (Provide complete Sodal Security Number [for example, 123.451789], names, including middle names or initials, and addresses on the bonds M~`~[~:i-~~ ~'_~ C:;t2~~~ocjtv.(~t~;E Eity `t,~,~-~:i i.`~3~~1 U~ I~ 7~ 25 ~~24:3c,`(d=~c`"r•~~ S~ t`'1-1 -v; - S~`~~`> J~(~ t~~72 2~ C~~~~c~~~5~~''1~+~~,C ~`7 CC>~N~~~ ~r`rvE ~~.t~ j~i~2 2~ C~~c~4:51C~'I~-~~ C~IaMP %i,i1~1- P,'~ I~i~ ~il /-~,U C-i I `17~ L_7 CGi 5 ~ ~> ~ 5 Z~} ~ `-t I r G f P ' " ~ n :7 t~M~ ~-~ _r Gv N ~~iuCa 1`~ 7~ ~7 Cx54v~,5~c.; G51L" . 5 C ~ i ~i ~~. ~`~ ~ f7CfUCvJ `I"! 7~ ~1: C 3 c, i l `'1 ~I %' ~ 5 ~;,~ 7 D LZ 4-> zj (~, U r LUG c:~ i i`1Z2 [ `_~ C~!~UC'~ 5.72vvy~ N~Ji~~7Z ~~...5 ~t5v~iv~`,nat~~ D=~=t ~7 ~2 L ~ Cx'ScL~u zi-voo Y ~~ r: J/~N "~ 13 ., _~ ~`~ ~ 5o5o`f3 I C~`17t% t'Er~ i ~) "1 ~, ~ ? ~ 5v 7 I ~ ii• ~ 7 i I C ~. x'c ;' (Signature) & T BANK ,~ NlGHIAt\l~ r ~. ~>;~ ~y ~ ~ ~; ~ JAN 1 9 ?r1? { 1~~~• y t i'~~~ c ~-r~ C 8 ~~~ ~~ ~-- ~ ~~' <; Print Refresh PD F 3500 Department of the Treasury Bureau of the Public Debt CONTINUATION SHEET FOR LISTING SECURITIES (Revised January 2007) PRINT IN INK OR TYPE ALL INFORMATION The bonds described on this form are included in the attached PD F ~ ~ ~ ~ E ISSUE DATE FACE AMOUNT BOND NUMBER INSCRIPTION (Provide complete Social Security Number [for example, 123-45-6789], names, indudin middle names or initials, and addresses on the bonds ~/1ARi~i13 -~ ~-`~ Ct~~7iv72~3~G i;IiJ ~~--(~i?~ ut ;v1~~R i~y ~ 3 25 c~ ~v--7 1 ~ ~ `7 i 3c~, E S ~~ ~ ~ ~ - v 3 - £3 5~ `~ ' Mrs. i ~i 13 L~ C~S~"~ - ~ ~,:~ (3l E PAD (ut ('-5 ~~-~/~`( J r_/~r-~ GC)N f-- ~ ~ APR -w~3 ~S c~~v~(~~il-3~,-~r D P~ l~( L. 7 GCS r~t.) r ~L 1 c~ -= MIRY i~, 7 ~ 25 C:~~v7 1 1 i 1 sZ2 E `; ~~r~nv Wit, ~ C~~1~1~.~~ MAY tw"7 3 ;?5 CxSc%7 1 i 2~~~?2E _ t~AY l`173 ~5 C.5v7 ] i ~c~7~`l~ ..JJN t°1~ ~ c'_S~ Gt5v=1 - ~-i-UUv~Z~ Jam!- i`1-l~ ~.`i (~?`~U'~i41 ~~Z4;E J i.l L i °i ~1 2J ~ 7 Ci(5 O`1 I '-}-z C! '-1.17 E ~~uv i~1~3 2~ 4~5ati i ti-_3 zw i~4r~ /~UC-r i ~I 7 ~ ~ 5 G~' SU ~ 1 ~-F'-~ v l ~~ ~ S ~P i~1~3 ~5 Q 5~3`~ 1 `~-5 9 ~t`ry. c;~.i ic~1?~ ~5 Q~li3~:"~7`t~v~~E ~- N ~~ ~/ i `~t "I =~ z 5 V} S 11 3 ~ `f l/ 17 ~ t= M & T BANi~C HIGNLAti~D PARK JAN 1 9 ~~oi~ G (Signature) ~ ~ ~% ~~L' ' ,// ~ ,~~ i ~ ~ ~~ ~__ ~ ~ ~ PD F 3500 ~ Department of the Treasury Bureau of the Public Debt (Revised January 2007) PRINT IN INK OR TYPE ALL INFORMATION The bonds described on this form are included in the attached PD F 1 ~ 2 L E ISSUE DATE FACE AMOUNT ___ BOND NUMBER _ _ INSCRIPTION (Provide complete Sodal Security Number [for example, 123~5~789], names, induding middle names or initials, and addresses on the bonds NUJ ;~h~3 ~~ ~~ i i 3(,~lalvZ~`j' E-If~ ~(~- ~ 1 Z-~ ?~~~! DEC i~-73 2~ CAS i 13c~~`IZ;Z S `=~ r `ice - c'> 3 - g~:~ -1~ DEG i'1"13 G5 ~5 1 1 3 ~-7£'~i2~ MRS l~MY J~-J C~~Ni~~~ ~L ~ Z JAN 1`~~~ 7~ C.~SI? ~;i:~~~~,a%g. N - 1 7 C :~ - ~ 2 i V E Ci~M~ NI1_l, t'/~ 1~Ui1 ~r ~ ~ ~,, S~~Mvi=-~- J LvNi ht7 M~~ i~i~~ 2~ c:ac~IZ~~~ ~`latjE M+~'1' 1~=11'-~ 2 5 C~ 5- L+ u 7 7 ti is ~ f E MAY i`'17~-} L~ (,~5i~+v-7~~~0~~;= M ~~`( I ~ 7'-f 2 ~ LY 5 r `t ~ ' 7 4.; ~7 G r `r !. JJN i'17'-~- 2`~ Q`~ i74~7~Zi26 Jt,l~ i~~~{ ~5 ~~; 7w37;? t;y~ .1u~ i==[~~+ 2~ G;?~i~C~~r.~~3Z2c /~UL~ IH~'~} ?5 ~ 5i~~3~~~-~Zc~E .~u~ 1~~~~-+ ~~ QSr~~~foy~l~~wF CCU D M & T BAN~C (Signature) HIGHLAND P;4P,K ~, 1i~ ,D / ;~~ JAN 1 9 X008 ~~ Print Refresh CONTINUATION SHEET FOR LISTING SECURITIES PD F 3500 F Department of the Treasury Bureau of the Punic Debt (Revised January 2!)07) PRINT IN INK OR TYPE ALL INFORMATION The bonds described on this form are included in the attached PD F frj ? ? E ISSUE DATE FACE AMOUNT BOND NUMBER INSCRIPTION (Provide complete Social Security Number [for example, 123-45-6789], names, indudrn middle names or initials, and addresses on the bonds) SAP I`17`-F G ~ 51`~?S~Sc~~S ~-iN 2(~~_ ~i27 3c>f `.~ c P t `(i `-F .~- `-~ G,% 5 19 Z 7 ? '->'-8 ~ G~ S `~ t '~1-1 - L~ a - ~'; S 7 S vc~~ f~~~`-f- 2~ C~~1`i=~~c ~12z°~C 1V1~'`~ ~~MY .~~~1J CoN?r'~D ~;~~ i~i~~ ~~ C,2~(`j ~~'3~7:'E (~ t:;ui N:t~ 7~?]v~ (j . ~ I `l 7 ~-(- L 5 X 7[ 7? (~ v 7 3~ ~ E ~- %~t !v~ P 1-t l L L ~A 1~ ~ I I G D ~ G i `~i ~ `t ~ ~ ~k S i `j ~ G~'t v '-F 7 V ~ ' J/~N ~`~-77 ~~ CY~?U~c~`1234o~i~ .l r~N t ~] ? 2 ~ ~ 5'~'~`i 3 Ito ~c~~ FF~ tG~_ 2~ (,~52c:-w~?4r I r~E F=CC i ~] ~ 7 2 ~ C;S?v ~; `~5 7frv 7 E f~/1~~~ l`=1~5 25 G~522 7zti-3~~o2E /~PK i ~ 7~ 2 S 6i 522 727 d~ t3 f'~P~ t °I ^1 ~ L `_j Gi S 2 2 7 Z(o i'; 3 b ~] E ~~'~ i~~~ `5 C~5227z7~,~"r~r~ ivtraY E~~ti 2 ~5~2 7"'`1G~3'~-~~ Print Refresh CONTINUATION SHEET FOR LISTING SECURITIES c~ U 7~0~- (Signature) Ni & T BANfC ~ /~ HIGNl.ANDPARK _ri~'/'~``~'~~ J~~ ~ f/ JAN 1 9 2008 - ~_ ! ' ~~ ~/ Print Refresh PD F 3500 E Department of the Treasury Bureau of the Public Debt CONTINUATION SHEET FOR LISTING SECURITIES (Revised January 2007) PRINT IN INK OR TYPE ALL INFORMATION The bonds described on this form are included in the attached PD F i ~ L ~ E ISSUE DATE FACE AMOUNT BOND NUMBER INSCRIPTION (Provide complete Social Security Number (for example, 123-45-6789], names, indudin middle names or initials, and addresses on the bonds JvNt~1~5 25 C~~i2Z~3iv~+vt<,1= t=icJ `.~- c~ t2.~ 3c~ ~ JiuN ~ ~1 ~S 2~ GcC~~%ivC~~+4545 S~~ 1 c~l~ - U3 - f3 S ~~' .,J ~ L I `'I ~ ~ 2 5 ~ 4; v ~ c; c 5 ° L v ~ E J~ ti.S ~ NAY J El~N ~; ~ N R~ 1~ ~= ,iui_ iw~~ 25 Glcac~~vv~~2~~SE --j C~G~N=~~ Ui2~ ~/~ t~cr1 aMP ~[L~ C JUL f`'175 25 ~(~:viv~72iv7'fiE f Jt /aUL~ i~1~5 2~ C~ ~Coi~07~1N~ l C- ~j ~~M~J~t_ -:T Gt~N~IkD ,~~(,~U t ~ 1 ~ ~ 5 C~~~y i ~.: ~i ~ 3 5~ E 13~r 1~11~ LS ~G,c~i-}"2.i~ `1'753E Nc J i ~1 ~ 5 ` 5 C~~ Co c:~ ~} 2 ~ i ! 12 `7 E Nov ~`17~i L5 G1~a~+Z22i2a»E ~E~ t`'I~5 25 C;t~v~+22~~+~~tii_ JAN ~~~~W ~'_5 ~G.:v~}F35 i 3°~~SE f-F I?~ i ~ 7i~ ~ ~ (,~lon~'-tl:~`1 3f=~+c1 i= r`a/g i r~~ 25 C~~c~w4L~~3L~f~ M & T BANK HIGHLAND PAflK (Signature) JAN 1 9 2008 ~. f//~f~/~ x~9'a1 PD F 3500 E Department of the Treasury Bureau of the Public Oebt (Revised January 2007) PRINT IN INK OR TYPE ALL INFORMATION The bonds described on this form are included in the attached PD F j S 2 ~ ISSUE DATE __ FACE AMOUNT BOND NUMBER _ ___ INSCRIPTION (Provide complete Social Security Number [for example, 123-45-6789], names, indudi middle names or initials, and addresses on the bonds) NtaP,iy~~, 25 c~~oG.•~-7~3~~~ ~ (ti L~:.- ~i2~ 3G i iW~ t;. 1~ 7 C; Z~ ~'` ~ c'~`' ~- 7 0 5 Lt Z 5 `~ S t `~ '7 - G 3- 2 7 5 N~~kR ~~ ~Co 25" ~covc~4~2`~ I~ E ~ 5 i~MY .) FJ~n1 Cc~N R/~~ qtr=. iy7ty Z5 C3(ov~y73~~Ib5E i-7 CufzN~L-~-- ~21VE i~~Y iy7~ 25 C:;?vv~~-t?37~~5r U (~ 5 ~MI~C~L S GC'f~~-~~ (ill f~Y i ~(7 - ~ S" ~~~~~ ~+~~-~~~ ~ SF ~~N i~~~ 25 C,~G~v£~+27v17Z~ .J U~ I X1'1 G~ ~5 G~ X08 ~t-~~ ~t~`i~~E ~~jj /-sue:, ('17c.-~ ~~7 ~J c~ 4~i7Ur~~~ J~77~~ AvC-r ~ 1 ~ l~ ZS C~~ ~ v 7b`i 2 3 ~ ~ ~ SAC' i~1~C; Z5 C~}(vio7 r~ Li~`i~tE S~.r i~-(-7~, Z5 C~wiv7~TrZc~y~E Si=P i~i~~ 25 C~t~; (i 3~i287~c~~ 5EP I~%i-l(o ZS C:Y~~t2~-I~o~~v3`1F_ ~~r i~1~(~ ~~i ~G~i2'-f~o~~7v~F v ~ ~i i ~~ ~~ 2 5 C' (0(2 ~i-v ~ ~~ z~ i~ ~ F NaJ ~y~L; 25 Q~~~~-~~::i9~.~2~_ ~~~~/ (q~~ ~~ C~G~13~7~7~i~or Print Refresh CONTINUATION SHEET FOR LISTING SECURITIES ,~ C ~ M & T BANK / / (Signature) HIGHLAND P:~nK //~~~~ ~ JAN 1 9 20~E ~ •~ ~~tiy~ (~~t ~~-/ J c~ ~~ PO F 3500 E Department of the Treasury Bureau of the Public Debi (Revised January 2007) PRINT IN INK OR TYPE ALL INFORMATION The bonds described on this form are included in the attached PD F _ j ~ '` 2 ~ ISSUE DATE FACE AMOUNT BOND NUMBER ____ INSCRIPTION (Provide complete Social Security Number [for example, 123-45-6789), names, indudin ntiddle names or initials, and addresses on the bonds) t~EC(~i7w ~~ ~(~13575c~~75E [=lt~l 2(v - G:l2S3v1 Di-G i~'i~(.; ~'S QG~[377~0o3~~ZE SS 1 q-7-G3 - c~ X15 JINN i ~ `17 25 (~;w1357~~t1:~-t7C M~5 i~MY J~.AN Cvti-2A~ Jr~N i ~I ~~ Z~ C~~(3578 3 ~ILf-E 1-7 G~.~N~~~ T~2~vE i=tri3 t ~~ 7~ Z5 C~ i1; [3 ~ ~ ~r 7 ~. ~+~t t C r~I~ P 1-1 ~ l_L p ~ t ~- v 1 i ~~~ i~77 25 Cx~,I~+5~5c;c7b~ o MF4~ iW"7"7 ~'~ ~G;+~F-5~~=~3~77~ Sr~MvGt-- ~' Gc~tv~~~ Zvi A R- t ~~ 17 ~~ ~ (~ i '-t S Y 7 (~ S v c M~kP i`-177 25 ~7L1~+5~'BZZ~~Z~ APR i°I~7 27 G~~[7o8c:.v Svc c ~~P12 i~~77 ~5 G,~~~7v~z~-~~7~tS E N~A•t' i`'t~7 ~.5 C~i.~17U~~~~~a~E iv-i~Y (~~ 77 2 5 ~~; I ~ ~~ ~~• `15 2 7 E Jury I~~~ ?S G;~i~l7c~-rv?~+~~~ ~J~N t`1~1~] L~ G2G~17v9 1 !!o Lt! r ,J~+N ~~~7 2~ ~i~i7Cta~~83`E f~i`1Ca I ~7 ~ ~ 5 ~~17 `12(0 3c~:~o`tE A~+~ !°t77 25 ~,;~tyr7~j2738~~{E 1~-UC~ 117 ~`~ Qlvi97~i ~•t~3L Print Refresh CONTINUATION SHEET FOR LISTING SECURITIES nl1 & T BANK j ~ ~ (Signature) HIGHLAND PARK ~ ~ /k~ ~ ~ C~ 9 ~ u ~ C~~~i~~`~cl~C ~( Cc~t JAN 1 20,.. - ~ ~ c Li~ PD F 3500 E Department of the Treasury Bureau of the PubBc Debt (Revised January 2007) Print Refresh CONTINUATION SHEET FOR LISTING SECURITIES PRINT IN INK OR TYPE ALL INFORMATION The bonds described on this form are included in the attached PD F ~ 5 Z ~ ~ ISSUE DATE FACE AMOUNT BOND NUMBER INSCRIPTION (provide complete social Seauity Number Ifor example, 123-45-6789], names, indudin middle names or initials, and addresses on the bonds StPI~'i?~] ~`j C~(~~97`333113 i~ iN ?~o - cwt 2301 S t= r i ~ 7 7 `5 Q Cv 1 `~ 7 3 2 Z (.~ 5`0 ' ~-~ ~~ t ~ -l - c.; 3 - ~ 5-15 QC:T i `'t 7~ ~ 5 ~ 4~ 2 i Z x-71'1 ~G ~ N~ i2S /AMY J ~.?tIJ ~_.oN -~R'T~ C~ c~ i i~=17-7 ~ S C~ G~2 i Z `3 ~ ~ ~ 3v C 0 7 Cc~ ~.N GL_z_ -D~R. i ~/ ucit~t~-7 2S" ~~Z1Z9~v1~1E L~~M~ H1r_i_ PA i-lo it jJC J i ti17 ~S" G~~;~ 13c'~ ; I! i u E v P N v v~ `i "7 ~ L 5 Cti3 lv 213 u v I Z 2 2 5 I~ M U G c..._ -~ C vtJ F~_..Ik~D M&T r3AN~ H1GNL~Nt1 ":'1f'K JAN 1 9 ~~~~ obi'/~~~,~~f ~~P`~/,~, ... .l~ .- .._ .. ,.._ -....~ ,..,- ... _.... _ _ - - _ -- __-- , ---, S :. . ,- a.P ~ ~ - _ - - ,.... ..., ~,,.a., _ ~.. _ _ ,_. _ .. M . _ . _ . . _ ._ _ ~_ ~~ .r ~ F . -- - -- - _ _.. __. ... .._. _..._.,. _____-~- - __ _--- -- -- - - -- -- - -._ef, _.,smeswitlbe !herewith certify, that 1 have this day carefully examined the following listcd and described article/articles for the purpose of Estate Va{ue, excluding tax, present for the Estate as follows: The following list of jewelry items represents a Fair Market Evaluation as November 14, 2007 (Date of Death) for the Estate of .. ,n: c~x~ ~ ,~ ~:~~ Shank Alteration: Shank Measurement: Gemstone Information: Total Weight: ~uti Arthritic sham: -Finger Mate Top: 2.OOrrtrn Bottom 2.25tttm Amount Cut 1 Fu0 7 Single .24ct t.d.w. Estate Value: Weight Measurements Clarity Color .17ct 3.70ttBtt VS 1/VS 2 WI .Olct 1.30mm VS 1/~ 2 y~l 5100.00 Wedding band 5300.00 lytgagement ring ! es~-r~ : the vzlue as listed for purposes stated above, excluding federal and other taxes. N making this appraisal, I do not agra to purchase or replace _ "' '' `'= e6 -" ^e ae to detetminc the existence of a fracture filling process with regard to diamonds and colored stones, no '°"'~'-~-"?' . ~- ~. _ _. - _ _ .. .- .~ -,-s ~ to ~.h~ existenct or notrexistena of such process. a~ ~.~ ~~ ate- > .; -.. - _ ~ ._ ~ ^.• ~, to ~tp action that tray be tafien c~ Nye t-~ ~s ~:::..:, ~.:. ,~ L .., ;k '•tik+:. t~ " ,~et.'~taT;&:~„,ut~~x~~ '_, f •~ ?szs, ~:ti.a~~' c .. m.,.., .,~ c:.~...- ~~~Z N O O rol ~o N 1 {{''~~ N 1 CrJ W O ~H7., x7 ~7 J ~ O )-' N rP N ~] d ~~~ 1 1 i H O ~ ~ H Vt y~ O Cr] O O 0 N N yy W gCrJ CI] ~ H O I~~~y C~~! O O O O O o~ ~~ H ~ H o ~y ~ w~ o°o~ ~o ~~~~ ~~~~ ~V~~~~~ N ~ ~ ~~~ ~ Ot~H l0 K fl~. .~~--. f ~ ~.~ J N j T X `y f F..+ ~o w ~ C/3 N ~ D ~ > ~1 ,~ Q~ ~ ~ ~~ O ,~ ,~~) I-~ O I N 1 N ~~ W 1 O J N J ~ 0 N N ~P N v e ~~~ 1 1 1 H O RJ N H U1 y~ O Cpl 0o d[1 o trJ N yy W Cl7tr]~H O ~" ~1 '~' N N (/) ~ C' 00 O o ~~~ O H H ~ ~ H '~ 0 w ~.. ~~ ~ J O Q ~ ~4 2 ~~~~ N o~~ W ~~ m o O /~ 00 J `Y ~r~~+ ~ IJ N .f' k r~~ ~ ~a N ~ b b ~{ a ... - a ~ ~ ~ cN ^C 1 n~ % ~%~}C_/f/~E~'T Lam' v " ~~. Investors Life ~~ Insurance Company of North America 6500 River Place Blvd. • Building One • Austin, TX 78730 (800) 925-6000 • www.investorslife.com April 11, 2008 THE ESTATE OF AMY J CONRAD C/O-JOHN H GROFF-EXECUTOR 1 CHELTON CR CAMP HILL PA 17011 RE: AMY J. CONRAD, DECEDENT POLICY#: 4000874617 CLAIM#: 32447 Dear Mr. Groff: We have completed our review and necessary processing of the above referenced claim. Enclosed is our check in the amount of $2,035.28 representing the total death benefit proceeds due under the policy. Life proceeds $2,000.00 Premium refund 35.28 Total $2,035.28 Should you have any questions regarding your claim, please feel free to contact our department toll free at 1-800-925-6000. Sincerely, Donna Calderon Sr. Claims Examiner Life Claims Department INVESTORS LIFE INS CO OF NORTH AMERICA CC: Genworth Life and Annuity Insurance Company P.O. Box 40012 Lynchburg, VA 24506 •oooooto2eooaooss6oosoo• n 0 0 0 0 M O 0 0 N O N AMY JEAN CONRAD 1 CHELTEN CIRCLE CAMP HILL, PA 17011 Quarterly Statement January 1, 2008 through March 31, 2008 Commonwealth Variable Annuity Plus Genworth Life and Annuity Insurance Company Customer Service 800 352.9970 Available: Monday-Friday Sam - 8pm EST Website www.genworth.com Web Assistance 800 404.2958 Available: Monday-Friday Sam - 8pm EST Contract #: 706064411, Effective 11/14/1996 Type: Non-Qua! Owner: AMY JEAN CONRAD Annuitant: AMY JEAN CONRAD Registered Representative: GLYNN DAVID BIAS STIFEL NICOLAUS & CO. INCORPO 214 SENATE AVE STE 601 CAMP HILL, PA 17011 Contract Summary ~ i !Curre:nt Allocation by Asset (crass i ~ This chart is intended to help you identify the extent to which your investment is diversified among asset classes. I~ ®479'o Fixed a 29% Balanced 14°~ Large Cap Value 10% Large Cap Growth ~ Includes payments and any bonuses applicable. z Includes investment gains and losses, interest credited, and charges for any applicable fees and special features. s Values do not reflect any surrender charges that might be applicable. 38256 01!01/06 Page 1 of 3 04/01 /2008 Quarterly Statement Genworth Life and Annuity Insurance Company Contract: 706064411 Owner: AMY JEAN CONRAD 01 /01 /2008 - 03/31 /2008 Quarterly Subaccount Summary Beginning Purchases Redemptions Ending Ending Ending Value ($) ($) ($) Units Owned Unit Value Value ($) Balanced Janus Balanced Portfolio 34,382.42 0.00 0.00 1,113.7691 30.414088 33,874.27 Large Cap Growth Janus Forty Portfolio -Institutional Shrs 12,013.43 0.00 0.00 321.471fi 34.978340 11,244.54 Large Cap Value Fidelity VIP Equity-Income Portfolio 17,826.34 0.00 0.00 295.0263 54.368202 16,040.05 SUBTOTAL ~ 64,222.19 0.00 0.00 61,158.86 Interest Fixed Account: Credited Fixed One Yr Guarantee Account 53,338.84 0.00 0.00 522.68 53,861.52 TOTAL 117,561.03 0.00 0.00 115,020.38 Optional Programs and Riders Selected Dollar Cost Averaging Bank Draft Systematic Reset Optional Riders Rebalancing Systematic Withdrawal 0 Automatic Required Minimum Distribution Asset Allocation Program , If you are participating In the Asset Allocation Program and have invested assets In an Asset Allocation Model: The composition of the Asset Allocation Models will be updated periodically. When your Model is updated, we will reallocate your Contrail Value (and subsequent purchase payments, if applicable) in accordance with any changes to the Model. You may reject a change in a Model and "opt out" of the Program. Please note that, if you have elected certain optional riders and you reject the change, your benefits under the applicable rider may be reduced if your total Contract Value is no longer invested in accordance with the prescribed Investment SVategy. Transfers of Contract Value that are made as a result of Model updates or automatic monthly rebalancing do not count as transfers for purposes of calculating the number of transfers made in a calendar year. Please read your prospectus and the brochure for the Asset Allocation Program for more information. To stop receiving paper and view your statements online visit us at: www.f~efinancialservice.com/edoc.html Page 2 of 3 04/01/2008 AIG Annuity Insurance Company ~ P.O. Box 871 Amarillo, Texas 79105-0871 800.424.4990 APRIL 25, 2008 CAROL S GROFF 1 CHELTEN CIRCLE CAMP HILL, PA 17011 RE: C~ntr_ac~$J1291~36 _ Dear CAROL S GROFF: We are pleased to advise you that we completed processing your claim for annuity benefits on April 25, 2008. In order to provide you with the benefit of flexibility in disbursing your funds, we have opened an AIG Annuity Bridge Account for you. The total amount of your claim proceeds is $67,667.73. The beginning balance of your AIG Annuity Bridge Account is $64,548.61, as described below: Non-Taxable Amount $52,072.13 Taxable Amount $15,595.b0 Federal Tax Withheld $3,119.12 State Tax Withheld $0.00 $64,548.61 The taxable portion will be reported on Internal Revenue Service Form 1099-R. Your account will earn a competitive rate of interest and provide immediate access to your funds with no monthly service charge. Interest earnings on your AIG Annuity Bridge Account will be reported as required by the Internal Revenue Service. State Street Bank and Trust will mail your new account kit shortly. The kit will include your personalized checks and a detailed explanation of your AIG Annuity Bridge Account. If you should have any questions, please call 1-800-331-4631. Sincerely, ,~ c I?~ B. N. Graves Manager Annuity Claims ) /~ 1 .~ ~C 171 /7 ~ N i tl f J AIG Anrmin~lnsrvnrece Conrpane Mernher nj Aurericnn Ltrernatumu( Group, lur. S. BERME SMITH Attorney-at-Law 107 N. 24"' Street Camp Hill, PA 17011-3602 PHONE: (717) 737-6789 FAX: (717) 737-6783 August 12, 2008 In re: Estate of Amy Jean Conrad; DOD 11-14-2007; SS# 197-03-8575; EIN: 26-6125301 PA File No. 21-07-1094 My file: 60002 Ms. Glenda Farner Strasbaugh Register of Wills Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 Dear Ms. Strasbaugh: The original and a copy of the Pennsylvania Inheritance Tax are enclosed. Also, please find enclosed the Estate's check #116 in the amount of $21,544.53, payable to Register of Wills, Agent, as final prepayment of the Pennsylvania Inheritance Tax. My check in the amount of $15.00 is enclosed to pay the filing fee. Please acknowledge receipt of this filing. Thank you for your help in the case. It is a pleasure to work with your Staff. Sincerely yours, S. Berne Smith Enclosure: cc: John H. Groff, Executor _~ -- « _:_; - ~~. ~' ~ .~ :> . _ c _ -,-, -. ~~ _~-~ .~- ~ ~~ *,~ _^ ~ ~ ~ ~N 1 d or ~'+~.r`Q r ~~-• Z cfi ~ S ~ J r _---r'- i e z C' z~ o ~ e d] ~' ~_ ~ °v ~_ Q s O CJ r a w M ~~ ~ r W ~ Q ~ ~' o -~ d C!1 r+ ~ ~ M r N ~ ~ ~ ~ ~ ~d Wo~,~ ~~ ~ oo-` ~, o ~ ~ bn ~°~ ~R3 ~ ~' U ~ ~ ~ U ,~ U O N